I’m the Director of Operations at Neurotech, a company that offers in-home monitored ambulatory EEGs throughout the United States and cEEG monitoring for ICUs and EMUs. I manage the operations and EEG services, including scheduling, coordinating technologists and equipment, monitor processing, and review of data managing resources. I also oversee infection prevention and research EEG. I write this article for ASET’s Neurodiagnostic Week to share my experience during the COVID-19 pandemic.
COVID-19 had a huge impact on our patients, technologists, and company. At the beginning of the pandemic, in-home EEGs sharply decreased when all non-urgent procedures were put on hold. However, it quickly became apparent that many epilepsy patients still needed EEGs. With EMUs closed, the American Clinical Neurophysiology Society (ACNS) recommended that depending on the urgency of the request, in-home ambulatory EEG or in-home ambulatory video EEG monitoring should be considered a safer option. Accordingly, our technologists provided in-home EEGs to patients throughout the pandemic.
Keeping patients and technologists safe while providing much-needed services in times of a pandemic became our number one priority. While it was challenging to overcome many COVID-19 hurdles, it ultimately led to positive changes. It triggered an improvement in work processes and implemented new policies, resulting in improved infection prevention and safety standards. As a result, today, we are a stronger and better company for our patients and technologists.
Initially, our biggest challenge was the lack of clear guidelines for performing EEGs in-home safely with COVID-19 spreading in the community. Early in the outbreak, the Centers for Disease Control and Prevention’s (CDC’s) recommendations for healthcare personnel changed frequently, and different regions of our operations were affected differently. We had to make sure our infection prevention measures were effective against the virus, and technologists had appropriate personal protective equipment (PPE) to use in an in-home setting. Without rapid COVID-19 testing reliably available at all of our sites, we relied on effective health screening procedures for patients and technologists and infection prevention measures to protect patients and techs against the virus.
We developed a COVID-19 Risk Management Plan, infection prevention protocols for technologists and implemented changes to existing processes. As part of these adjustments, we revised our existing pre-appointment health screening questionnaire, completed patient history via phone before the appointment and took additional steps to reduce time spent in the home, such as individual patient supplies kits, and switched from collodion to Tensive® to avoid aerosol transmission. Plus, we stopped hyperventilation and limited the number of family members in the room during EEG set-up, in addition to enhanced PPE and disinfection protocols. We also implemented new infection prevention policies for offices and modified services to allow some administrative staff to work from home if necessary.
Shortage of necessary PPE and disinfectants was another challenge early in the pandemic. PPE is essential for our operation, and we had to be able to provide them for our technologists, but we could no longer buy them from vendors of medical supplies. At one point, in the spring of 2020, we bought face masks and face shields from a printing company in Chicago that was turned into a PPE producer during the pandemic. They were then shipped to all of our locations. Hand sanitizer was acquired locally in each state from distilleries that had switched to producing hand sanitizer.
Staff and patients’ anxiety was also a factor, especially during the initial lockdowns when we were the only cars still driving on empty streets to patient’s homes. Technologists feared for their own safety and their families. To help ease technologists’ anxiety, we held COVID-19 info sessions with questions and answers led by infection preventionist specialists, frequently updated them on CDC recommendations, and made sure they felt safe. Our set-up technologists were amazing throughout the pandemic. They understood their role and responsibility as healthcare providers. They trusted our protocols and knew that for patients with active seizures or new seizure onset, the need for EEGs was greater than the risk associated with the pandemic — their diagnosis and treatment depended on our tests.
Patients also feared for the safety of their families when allowing a technologist to come to their homes. We explained our COVID-19 procedures, PPE and safety measures to patients and worked with ordering physicians to prioritize safely scheduling patients in high-risk groups. Research EEG appointments were initially suspended and later resumed with increased COVID-19 safety measures.
ASET’s COVID-19 resources were invaluable, especially early in the pandemic. They were very specific and helpful during this uncertain time. Having links to ACNS and NAEC recommendations all in one place was beneficial. The ASET Townhall meeting gave us the opportunity to ask questions. It also provided essential guidance and reassurance on our infection control measures were correct. The Townhall was attended live and appreciated by many techs, supervisors, and administrators in the field. Especially in times of crisis, we all look to ASET for answers, leadership, and guidance.
Author: Magdalena Warzecha, BS, R. EEG/EP T., CLTM, Director of Operations, Neurotech
This guest blog is written as part of ASET’s Neurodiagnostic Week story series that highlights the experience of Neurodiagnostic technologists during the COVID-19 pandemic.